Key result
Transseptal left-sided radiofrequency ablation with a single 60-second lesion cured intractable AVNRT in a 13-year-old after conventional right-sided ablation failed.
Case Report (n=1)
No
Demonstrates that a transseptal left-sided radiofrequency ablation approach at the posteroseptal mitral annulus can safely and effectively cure intractable AVNRT in a pediatric patient when conventional right-sided ablation fails.
Answers are grounded in this paper and cite their sources.
May warrant left-sided ablation consideration in refractory pediatric AVNRT; leaves open generalizability beyond this single case.
Atrioventricular nodal reentrant tachycardia (AVNRT) is the second most frequent form of paroxysmal narrow complex tachycardia in the pediatric population.1,2 A conservative approach is used for ablation in children because of anatomical limitations and risks related to a permanent pacemaker in the case of atrioventricular nodal conduction damage. Cryoablation has emerged in the first years of the millennium and propagated thanks to the minimal risk to the native conduction tissue. Many reports in the literature advocate this approach as the gold standard combining high rates of success with optimal procedure safety and minimal risks.
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Brugada et al. (2015) conducted a case report in Intractable typical slow-fast atrioventricular nodal reentrant tachycardia (AVNRT) (n=1). Left-sided radiofrequency ablation via transseptal approach at the posteroseptal aspect of the mitral annulus was evaluated on Non-inducibility of AVNRT and freedom from palpitation recurrence. Transseptal left-sided radiofrequency ablation with a single 60-second lesion cured intractable AVNRT in a 13-year-old after conventional right-sided ablation failed.
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